Kansas lawmakers grill KDHE secretary, KanCare contractor over backlog: 'This is life and death'

Maximus GM: 'This is fixable. This is fixable and we will fix it'

By Justin Wingerter, August 04. 2016

Sign outside the KanCare Clearinghouse is pictured

State lawmakers peppered a KanCare contractor with questions and
complaints Thursday during a tour of the state's Medicaid clearinghouse
in south Topeka. (Photo by Keith Horinek/Topeka Capital-Journal)

Hours after they interrogated a KanCare contractor about the state’s Medicaid application backlog Thursday, members of a legislative oversight committee turned their focus to the Kansas Department of Health and Environment secretary.

“I’m frustrated. I’m truly frustrated,” said Rep. Daniel Hawkins, R-Wichita, the committee chairman.

Hawkins told KDHE Secretary Susan Mosier the story of a person who applied for services in October, was denied services in January, died in March and still hasn’t received a response from KanCare.

“People should not have the experience you just described. That is unacceptable,” Mosier said.

She said the backlog, which once numbered more than 15,000 unprocessed applications, is now at 3,587 unprocessed applications. She will present that figure to federal regulators Friday. Disability rights advocates have asked the federal government to intervene if the backlog lingers.

Several lawmakers bemoaned the onerous application process for Medicaid benefits.

“It’s a 200-page application process for long-term care services. Two-hundred pages,” said Sen. Jim Denning, R-Overland Park. “So it’s going to be a horrible process no matter how you skin the cat.”

Sen. Laura Kelly, D-Topeka, said she needed more than a week to complete an application for her daughter. She questioned why the state doesn’t have navigators — similar to those created under the Affordable Care Act — to help people complete their applications.

“If we really wanted people to be able to get on Medicaid rolls, we would create those kinds of positions,” Kelly said.

Mosier said there are 18 outreach workers across the state for that purpose. She argued people who have bad experiences with KanCare are more likely to speak out, leading to negative perceptions of the program. The claim drew a strong rebuke from Rep. Jim Ward, D-Wichita, who said he “rejects categorically” the theory “that the only people who complain are the complainers.”

Mary Tibbets, a safety net coordinator at Stormont Vail Health in Topeka, said state agencies need to work more closely with medical providers to prioritize the applications of people in hospitals. Still, Tibbets said the KanCare system is improving.

“It has gotten better. It is getting better all the time,” she said.

Tibbets said Stormont Vail is holding more than $2 million in liability for pending Medicaid patients. Linda MowBray, with the Kansas Health Care Association and Kansas Center for Assisted Living, also said care providers are not being compensated by state agencies in a timely fashion.

“I hate to use this word but I’m going to,” she said. “We’re in a crisis.”

Rocky Nichols, director of the Disability Rights Center of Kansas, urged KDHE to inform Medicaid applicants of their right to appeal being backlogged and tell them their Medicaid bills can be paid up for up to 90 days before they filed their application.

“Kansas is not doing this,” Nichols said. “It looks like Kansas is purposefully trying to hide the ball and be less transparent.”

Earlier in the day, the lawmakers peppered Maximus, a KanCare contractor, with questions and complaints during an hour-long tour of the state’s Medicaid clearinghouse in south Topeka.

“We’re talking about life and death issues here,” said Sen. Michael O’Donnell, R-Wichita.

Hawkins told Maximus executives that some of his constituents have been forced to send the same documents several times after Maximus lost them.

“Where the heck are these documents going?” he asked. “I want to know what’s happening, why that’s happening.”

Ilene Baylinson, Maximus’ general manager for U.S. health, repeatedly explained the complexities of the application process and how a document could be lost. Some documents are not identifiable because of poor handwriting or poor faxing, she said, but pledged Maximus would improve.

“This is fixable,” Baylinson said. “This is fixable and we will fix it.”

The company hired 70 people this year to reduce the backlog, Maximus executives said. Rep. Willie Dove, R-Bonner Springs, asked why the company waited until 2016 to bring in more employees.

“Should we probably have had more people sooner? Probably,” Baylinson responded.

On several occasions, lawmakers told stories of their constituents waiting six months or longer for applications to be processed. Hawkins talked about the constituent who died before an application was processed. Kelly showed Baylinson a constituent’s story on her phone.

“This is what I’m talking about,” she said. “This is from a dialysis center, this is life and death.”

O’Donnell and others questioned why Medicaid applicants are not told their documents have been received by Maximus. If they knew to expect that notification, Medicaid recipients would quickly know if the contractor had not received their paperwork, O’Donnell said.

“These are standard processes in modern, everyday situations,” he said, calling Maximus’ decision to not do so “mind-blowing” and “completely unacceptable.”

Baylinson reiterated that the application process is “painstakingly complex” and said she hears about the backlog problems, just as lawmakers do.

“We certainly understand because we get the calls,” Baylinson said, later telling Hawkins, “We hear the frustration probably even more than you do.”

During the tour, lawmakers in a bustling call center were told call volume increased 140 percent in 2016 when compared to 2015. Average call time has gone down to two minutes and 53 seconds, according to William Rice, a manager at the clearinghouse.

Justin Wingerter can be reached at (785) 295-1100 or justin.wingerter@cjonline.com.
Follow Justin on Twitter @JustinWingerter.

 

http://cjonline.com/news/2016-08-04/kansas-lawmakers-grill-kdhe-secretary-kancare-contractor-over-backlog-life-and-death

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